To evaluate the effect on loe-dose enalapril(ACE inhibitor), we administered a single dose of 10 mg/day enalapril to 22 patients(6 mild hypertension and 16 moderate hypertension) for 12 weeks. The systolic and diastolic blood pressures of patients were declined significantly at 4th week and at 12th week(p<0.005) without significant change of rate and body weight. These data were also analyzed in terms of the percent of patients with marked, moderate and mild responses. Enalapril yielded a 72.7% response rate in marked fall and 22.7% response rate in moderate fall which revealed 95.4% of good response rate. Enalapril was tolerated and showed no significant clinical and biochemical adverse reactions. In conclusion, these results indicate that monotherapy with enalapril 10 mg in a single daily dose was effective in the management of mild to moderate uncomplicated essential hypertension and was well tolerated.
Body Weight ; Enalapril* ; Humans ; Hypertension*

No abstract available.
Animals ; Enalapril* ; Nicardipine* ; Nitroprusside* ; Rats* ; Skin*

BACKGROUND: Imidapril is a long-acting angiotensin converting enzyme inhibitor, which has been demons-trated to be effective in reducing blood pressure. The purpose of this study is to compare the antihypertensive efficacy, safety and tolerability of imidapril and enalapril in patients with stage 1 to 2 essential hypertension. METHODS: In this double-blind, double-dummy, randomized, parallel study, the efficacy, safety and tolerability of once-daily imidapril versus once-daily enalapril were evaluated in 84 patients with stage 1 - 2 hypertension during 8 weeks. If antihypertensive response was insufficient after 4 week treatment period, the dosage for both study drugs doubled until the end of study. RESULTS: Data from 84 patients who completed the study were eligible for per-protocol analysis. An adequate antihypertensive effect was observed in 47.6% (20/42) in the imidapril group and in 23.8% (10/42) in enalapril group. There was statistically significant difference between the two treatments in the percentage of patients achieving a "reduced blood pressure". The pulse rate did not changed in both groups. Safety profiles were similar between treatments. CONCLUSION: In patients with mild to moderate hypertension, the imidapril group showed better response with regard to antihypertensive effect. Both imidapril and enalapril were well tolerated with similar safety profiles.
Blood Pressure ; Enalapril* ; Heart Rate ; Humans ; Hypertension* ; Peptidyl-Dipeptidase A

To observe the antihypertensive effects of the angiotensin-converting enzyme inhibitor, enalapril, a daily average dosage of 20mg was administred to 38 patients with essential hypertension for 4 weeks. Changes in blood pressure and heart rate, and the frequencies of adverse reactions during the drug administration were constantly observed. At the end of the 4th week of administration the mean diastolic blood pressure decreased from 104+/-11.3 to 91+/-7.9mmHg(<0.001), and the mean systolic blood pressure from 165+/-16.8 to 142+/-10.6mmHg(P<0.001), An effective antihypertensive action of enalapril was observed in 31 out of 38 cases(82%), and normalization of diastolic blood pressure below 85mmHg was shown in 27 cases(71%). The most remarkable antihypertensive effects were shown at the end of first week, and the effect increased progressively until the end of 4th week of therapy. There were no significant changes in heart rate during the observation period. Adverse reactions occured in only 7 cases(18%). These reactions included headache, dizziness, fatigue, skin rash and facial flushing in the order of frequency. Almost all of these reaction were mild and transient, disappearing spontanously without discontinuation of the medication. In conclusion, enalapril seems to be a safe and effective primary antihypertensive drug for the treatment of essential hypertension.
Blood Pressure ; Dizziness ; Enalapril* ; Exanthema ; Fatigue ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension

Erythrocytosis after kidney transplantation is common complications of Renal Transplantation. It afflicts 5~15% of renal transplant recipients and is associated with an increased incidence of thromboembolic events. It is correlated with use of cyclosporine, sex, posttranaplant renal function and type of antihypertensive medications. Invasive therapies for posttransplant erythrocytosis is serial phlebotomy and native nephrectomy. Usually medical therapy with Renin-Angiotensin inhibitor is preferred to invasive therapies. This drug lowers serum level of erythropoietin and then effectively lowers the hematocrit and hemoglobin level. We report the case of a 31-year-old male who had erythrocytosis after renal transplantation. Its hematocrit level is 60% and hemoglobin is 20.2 g/dL. We treated this patient with serial phlebotomy and Enalapril.
Adult ; Cyclosporine ; Enalapril ; Erythropoietin ; Hematocrit ; Humans ; Incidence ; Kidney Transplantation* ; Male ; Nephrectomy ; Phlebotomy ; Polycythemia* ; Transplantation

Toxic epidermal necrolysis (TEN) is a rare, acute and life-threatening cutaneous drug reaction. TEN is characterized by the sudden onset of extensive necrosis in the epidermis and frequent mucous membrane involvement. The pathogenesis has not yet been elucidated. In addition, no particular treatment for TEN has been established. We report a case of TEN in a 14-year-old-boy, which might have been caused by steroids with enalapril treatment for membranous nephropathy. He recovered after intravenous immunoglobulin therapy.
Enalapril* ; Epidermis ; Glomerulonephritis, Membranous ; Immunization, Passive ; Mucous Membrane ; Necrosis ; Steroids ; Stevens-Johnson Syndrome*

Enalapril, a new angiotensin converting enzyme inhibitor,was administered in 30 hypertensive patients for 12 weeks or longer in order to evaluate the antihypertensive effects and side effects (in some cases combination with hydrochlorthiazide). The doses were from 10mg to 40mg once a day. The results were as follows : 1) Before medication and 2, 4, 6, 8, 10 and 12weeks of medication, the average systolic and diastolic pressure were 176.7+/-16.0/108.6+/-7.6, 146.0+/-12.5/91.7+/-6.9, 138.3+/-16.1/87.3+/-10.6, 140.7+/-13.9/87.3+/-9.6, 137.3+/-13.5/87.7+/-9.1, 137.3+/-14.8/87.0+/-8.5, 138.7+/-15.4/87.3+/-9.1mmHg respectively. After 12 weeks of medication, marked or moderate degree of anti-hypertensive effect was observed in 90% of all cases (p<0.005), and the further significant decease of systolic blood pressure after 4 weeks compared with 2 weeks (p<0.025) was observed. 2) There was no significant change in pulse rate before and after medication. 3) There was no significant change in the laboratory findings such as fasting blood sugar, serum BUN, creatinine, cholesterol, GOT, GPT, blood WBC, hemoglobin, hematocrit, and urine protein before and after treatment. 4) The side effects of enalapril were observed in 2 cases of 30 cases (6.6%), mild dizziness and mild fatigue, which were not required discontinuing the medication or decreasing the dose.
Blood Glucose ; Blood Pressure ; Cholesterol ; Creatinine ; Dizziness ; Enalapril* ; Fasting ; Fatigue ; Heart Rate ; Hematocrit ; Humans ; Peptidyl-Dipeptidase A

OBJECTIVE: Angiotensin-converting enzyme inhibitors have been shown to improve survival in patients with congestive heart failure. To evaluate the efficacy of enalapril in patients with dilated cardiomyopathy during concurrent treatment with digoxin and diuretics, the peak rates of left ventricular movement were assessed after 6 months of follow-up by digitized echocardiography. METHODS: Using a high quality digitizer, continuous measurement of left ventricular dimension and its rate of change (dD/dt) were obtained throughout the cardiac cycle. Normalized rates of wall movement (dD/dt/D) were used for comparison. RESULTS: 1) Compared with control subjects, patients with dilated cardiomyopathy showed much lower Peak(-) dD/dt and Peak(-) dD/dt/D. 2) Peak(+) dD/dt and Peak(+) dD/dt/D were also depressed in patients. 3) Peak dD/dt improved significantly (p<0.05) in the enalapril group (n=16), but did not change in the conventional treatment group (n=20) after 6 months. Peak dD/dt/D improved approximately (p<0.005) in the enalapril group. 5) There were no deaths in 2 treatment groups during initial 6 months, but 3 patients in the conventional treatment group died suddenly during 1 year of follow-up. CONCLUSION: The present study has shown that left ventrieular Peak dD/dt and Peak dD/dt/D are significantly depressed in patients with dilated cardiomyopathy. Enalapril appears to provide well-tolerated and effective long-term therapy by improving peak rates of left ventricular movement in patients with dilated cardiomyopathy.
Angiotensin-Converting Enzyme Inhibitors ; Cardiomyopathy, Dilated* ; Digoxin ; Diuretics ; Echocardiography ; Enalapril* ; Follow-Up Studies ; Heart Failure ; Humans

Primary aldosteronism is present in approximately 1% of unselectd hypertensive patients. Adrenal adenoma is a known as one of the surgically curable form of the hypertension. Hypertension is one of the contributing factors for the development of aortic dissection. Cincurrence of aortic dissection in patient with primary aldosteronism is extemely rare. Only one case wasconfirmed by autopsy and reported in the world literature. We report a case of DeBakey type 3 anortic aneursm in a 49-year old hypertensive female patient with primary aldosteronism due to left adrenal adenoma. She underwent left adrenalectomy uneventfully after stabilization of her blood pressure with maximal medical management including nitroprusside, aldactone, enalapril and inderal.
Adenoma ; Adrenalectomy ; Autopsy ; Blood Pressure ; Enalapril ; Female ; Humans ; Hyperaldosteronism ; Hypertension ; Middle Aged ; Nitroprusside ; Propranolol ; Spironolactone

BACKGROUND: Left ventricular hypertrophy(LVH) is the independent poor prognostic factor in hypertensives. But, it is uncertain that the reduction of LVH by antihypertensives therapy will improve the prognosis of hypertensive patioents. THe effect of reduction of LVH on LV function(espacially diastolic function) and the mechanism of reduction of LVH are not clarified also. The aim of this study was to ascertain whether reduction in LV mass with enalapril has a beneficial effect ofn LV diastolic filling in hypertensive patients with diastolic dysfunction. METHODS: Mild to moderate hypertensive patients were treated with enalapril(10-20mg once daily) for 4 months. Their blood pressure and pulse rate were regularly measured devery 2 weeks. Using M mode echocardiograms, LV dimensions at end-diastole and end-systole, thicknesses of ventricular septum and LV free wall were measured. LV ejection fraction(EF), LV mass index(LVMI) and total peripheral resistance(TPR) were calculated. Pulsed ddoppler examination of transmitranl flow for assessment of LV diastolic function was performend from apical four chamber viw. The peak flow velocities of the early and late waves and their ratio(PFVE, PFVA, PFVE/PFVA) were measured from consecutive 3 cardiac cycles. In addition, the time velocity integral of the early and late waves and their ratio(EA, AA, EA/AA) were measured. Echocardiographic evaluations were performed at baseline and at the end of treatment. RESULTS: Average systolic and diastolic blood pressure decreased after treatment with enalapril. But there was no significant difference of pulse rate between basal and after treatment. The LV dimensions at end-diastole and end-systole and the thickness of LV free wall didn't change significantly. The thickness of interventricular septum, LVMI and TPR reduced significantly after treatment. The ejection fraction of LV didn't change significantly after treatment. There was no significant change in PFVE, EA, AA and EA/AA. But PFVA was significantly decreased after treatment with enalapril for 4 months. PFVE/PFVA was significantly increased also. CONCLUSION: In conclusion, antihypertensive treatment with enalapril led to a significant reduction of LVH partially associated with improvement in LV diastolic performance and no deterioration of LV systolic function.
Antihypertensive Agents ; Blood Pressure ; Echocardiography ; Enalapril ; Heart Rate ; Humans ; Hypertension* ; Prognosis ; Ventricular Septum